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Full text of "Medical Jurisprudence And Toxicology"

MEDICAL JURISPRUDENCE

and dyspnoea.   Clonic  convulsions  may  sometimes  occur.   It  has   caused
insanity and idiocy.

Fatal Dose.-This is extremely variable. Two grains - of chloxzlhyteate
contained in half a teaspoonful of sedative syrup proved fatal to an infant,
Tdly^old See grainfhave also kiUed a child, 1 year old. Twenty grams
haveycaused the delth of an adult, but as a ^^^^^^g^
would produce dangerous symptoms in an adult. On the other hand re-
Tveries have followed much larger doses. In one instance, a man, about
35 yeis old, swallowed no less than 595 grains dissolved m lemon syrup,
but recovered in about 3 days.53

Fatal Period.—The usual fatal period is about 8 to 12 hours but death
may occur within a few minutes or may be delayed for two to three days,
Treatment—Give emetics or wash out the stomach with warm water.
Alkalies may be given to decompose chloral hydrate ™™f™™%1* ™e
stomach. Keep up the body heat by the use of hot water bottles, blankets,,
massage, friction and galvanism. Keep the patient awake by flicking -ttieN*
face with wet towels, by shouting at him, or by administering strong.coffee
.by the mouth or by the rectum. Give hypodermic injections of strychnine,
caffeine, ether, etc. Perform artificial respiration and administer by inhala-
tion oxygen if necessary. Intravenous hypertonic glucose solution is also
useful.

In chronic poisoning the drug should be withdrawn, and tonics with a
liberal diet should be prescribed, It may be necessary to give stimulants,
such as strychnine and digitalis.

- Post-mortem Appearances.—Softening, reddening and erosion of the
mucous membrane of the stomach. The lungs, as well as the brain, are
congested and gorged with dark fluid blood. Fatty degeneration of the heart,
liver and kidneys may be detected in chronic poisoning.

Chemical Analysis.—The finely minced tissues are distilled with steam
in a 20 per cent solution of phosphoric acid. The distillate will give the
following tests for chloral hydrate : —

1.    Nessler's reagent added to a few drops of the distillate produces a
yellow to reddish-brown precipitate, changing to grey or black.

2.    Four drops of saturated phloroglucinol solution and 1 cc. of 20 per
cent sodium carbonate solution are added to 1 cc. of the distillate.    About
half-an-hour later the colour changes from pinkish-violet to orange, red and
deep red.   Chloroform and carbon tetrachloride do not give this reaction.

3.    About 0.1 g. of resorcinol and 1 cc. of 15 per cent caustic soda solu-
tion are mixed with 2 to 3 cc. of the distillate, and the mixture is boiled.   A
yellowish-red to red colour develops.

4.    Heated with caustic potash solution, chloral hydrate is decomposed
into chloroform and potassium formate.   Chloroform is known by its odour
and potassium formate by boiling it in solution with silver nitrate, which it
reduces to the metallic state.

Medico-Legal Points.—Chloral hydrate is often used as a hypnotic in
medicine; hence accidental poisoning, followed by death in some cases, has
resulted from its internal administration in too large doses. In 1925 a man,
aged 32 years, who was a victim to the opium habit, went to Lahore from
Jullundur and bought some drug in the hope of curing himself of the habit.
He took some of the drug and died immediately. The remaining portion of

52.    Pharm. Jour., May 22, 1943, Vol. 150, p. 187.

53.    Daley, Ind. Med. Gaz., Oct. 1905, p. 401.